United States District Court, S.D. Illinois
MEMORANDUM and ORDER
PHIL GILBERT UNITED STATES DISTRICT JUDGE
accordance with 42 U.S.C. § 405(g), plaintiff Kent
Purchase seeks judicial review of the final agency decision
denying his application for Medicare coverage as a disabled
individual pursuant to 42 U.S.C. § 423.
applied for Medicare coverage in October 2011 and alleged
that his disability began on May 16, 2011. (Tr. 115.) ALJ
Roxanne J. Kelsey denied the plaintiff's application on 3
March 2014 after holding an evidentiary hearing. (Tr. 11-18.)
The Appeals Council denied review, and the decision of the
ALJ became the final agency decision. (Tr. 1.) Plaintiff
exhausted his administrative remedies and filed a timely
complaint in this Court. Plaintiff is pro se here, but was
represented by counsel at the administrative stage.
Raised by Plaintiff
brief (Doc. 39), plaintiff argues that he is unable to return
to his past work and cannot do any job that requires
“excessive movement of [his] arms, knees, legs and
back.” He also argues that his conditions are getting
worse as he ages.
did not have the sufficient quarters of coverage to qualify
for Disability Insurance Benefits (DIB). He would be eligible
for Medicare coverage based on a period of prior government
employment, however, if he met the disability requirements
for DIB as of his date last insured for Medicare coverage.
See 42 U.S.C. § 1395c.
purposes of DIB, “disabled” means the
“inability to engage in any substantial gainful
activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death or
which has lasted or can be expected to last for a continuous
period of not less than 12 months.” 42 U.S.C. §
423(d)(1)(A). A “physical or mental impairment”
is an impairment resulting from anatomical, physiological, or
psychological abnormalities which are demonstrable by
medically acceptable clinical and laboratory diagnostic
techniques. 42 U.S.C. § 423(d)(3). “Substantial
gainful activity” is work activity that involves doing
significant physical or mental activities, and that is done
for pay or profit. 20 C.F.R. § 404.1572.
Security regulations set forth a sequential five-step inquiry
to determine whether a claimant is disabled. The Seventh
Circuit Court of Appeals has explained this process as
The first step considers whether the applicant is engaging in
substantial gainful activity. The second step evaluates
whether an alleged physical or mental impairment is severe,
medically determinable, and meets a durational requirement.
The third step compares the impairment to a list of
impairments that are considered conclusively disabling. If
the impairment meets or equals one of the listed impairments,
then the applicant is considered disabled; if the impairment
does not meet or equal a listed impairment, then the
evaluation continues. The fourth step assesses an
applicant's residual functional capacity (RFC) and
ability to engage in past relevant work. If an applicant can
engage in past relevant work, he is not disabled. The fifth
step assesses the applicant's RFC, as well as his age,
education, and work experience to determine whether the
applicant can engage in other work. If the applicant can
engage in other work, he is not disabled.
Weatherbee v. Astrue, 649 F.3d 565, 568-569 (7th
another way, the Commissioner must determine: (1) whether the
claimant is presently unemployed; (2) whether the claimant
has an impairment or combination of impairments that is
serious; (3) whether the impairments meet or equal one of the
listed impairments acknowledged to be conclusively disabling;
(4) whether the claimant can perform past relevant work; and
(5) whether the claimant is capable of performing any work
within the economy, given his or her age, education and work
experience. 20 C.F.R. § 404.1520; Simila v.
Astrue, 573 F.3d 503, 512-513 (7th Cir. 2009).
Court reviews the Commissioner's decision to ensure that
the Commissioner made no mistakes of law and that decision is
supported by substantial evidence. This scope of judicial
review is limited. “The findings of the Commissioner of
Social Security as to any fact, if supported by substantial
evidence, shall be conclusive. . . .” 42 U.S.C.
§405(g). Thus, this Court must determine not whether
plaintiff was, in fact, disabled at the relevant time, but
only whether the ALJ's findings were supported by
substantial evidence and that the ALJ made no mistakes of
law. See, Books v. Chater, 91 F.3d 972, 977-78 (7th
Cir. 1996) (citing Diaz v. Chater, 55 F.3d 300, 306
(7th Cir. 1995)). This Court uses the Supreme ...